BackgroundMetformin protection against cancer risk in Orientals is uncertain. We examined the possible metformin effect on total, esophageal, gastric, colorectal (CRC), hepatocellular (HCC) and pancreatic cancers in a Taiwanese cohort.MethodsA representative sample of 800,000 was drawn from the Taiwanese National Health Insurance data of 2000. A cohort of 480,984 participants 20 years or older, diabetes-cancer-free on 1st January 2000 was formed and categorized as four groups by DM and metformin usage status. Eligible incident cancer events had to occur one year after the index date until the end of 2007. The Cox proportional-hazards model evaluated relative risk of cancer for treated DM patients with or without metformin. The covariates included age, gender, other oral anti-hyperglycemic medication, Charlson comorbidity index (CCI) score and metformin exposure dosage and duration.ResultsWith diabetes but no anti-hyperglycemic medication, cancer incidence density increased at least 2-fold for total, CRC and HCC. On metformin, total, CRC and HCC incidences decreased to near non-diabetic levels but to varying degrees depending on gender and cancer type (CRC in women, liver in men). Adjustment for other oral anti-hyperglycemic agents usage and CCI made the benefit of metformin more evident [hazard ratios (95% confidence intervals): total 0.12 (0.08-0.19), CRC 0.36 (0.13-0.98), liver 0.06 (0.02-0.16), pancreas 0.15 (0.03-0.79)]. There was a significant gender interaction with metformin in CRC which favored women. Metformin dosage for a significant decrease in cancer incidence was ≤500 mg/day.ConclusionsMetformin can reduce the incidences of several gastroenterological cancers in treated diabetes.

Objective: To investigate the association between cooking behaviour and longterm survival among elderly Taiwanese. Design: Cohort study. The duration of follow-up was the interval between the date of interview and the date of death or 31 December 2008, when censored for survivors. Information used included demographics, socio-economic status, health behaviours, cooking frequencies, physical function, cognitive function, nutrition knowledge awareness, eating out habits and food and nutrient intakes. These data were linked to death records. Cox proportional-hazards models were used to evaluate cooking frequency on death from 1999 to 2008 with related covariate adjustments. Setting: Elderly Nutrition and Health Survey in Taiwan, 1999-2000. Subjects: Nationally representative free-living elderly people aged $65 years (n 1888). Results: During a 10-year follow-up, 695 participants died. Those who cooked most frequently were younger, women, unmarried, less educated, non-drinkers of alcohol, non-smokers, without chewing difficulty, had spouse as dinner companion, normal cognition, who walked or shopped more than twice weekly, who ate less meat and more vegetables. Highly frequent cooking (.5 times/week, compared with never) predicted survival (hazard ratio (HR) 5 0?47; 95 % CI, 0?36, 0?61); with adjustment for physical function, cognitive function, nutrition knowledge awareness and other covariates, HR was 0?59 (95 % CI, 0?41, 0?86). Women benefited more from cooking more frequently than did men, with decreased HR, 51 % v. 24 %, when most was compared with least. A 2-year delay in the assessment of survivorship led to similar findings. Conclusions: Cooking behaviour favourably predicts survivorship. Highly frequent cooking may favour women more than men.

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Objective: This study examined the effect of daily life reading activity on the risk of cognitive decline and whether the effect differs regarding education levels. Design: A longitudinal study with 6-, 10-, and 14-year follow-up. Setting: Face-to-face interviews with structured questionnaires at home. Participants: A representative sample of 1,962 Taiwanese community-dwelling older persons aged 64 and above, followed up in four waves of surveys over 14 years. Measurements: Baseline reading frequencies were measured based on a scale of leisure activity. The Short Portable Mental Status Questionnaire was used to measure cognitive performance. We performed logistic regression to assess associations between baseline reading and later cognitive decline. Interaction terms between reading and education were to compare the reading effects on cognitive decline at different education levels. Results: After adjusting for covariates, those with higher reading frequencies (≥1 time a week) were less likely to have cognitive decline at 6-year (adjusted odds ratio [AOR]: 0.54; 95% confidence interval [CI]: 0.34–0.86), 10-year (AOR: 0.58, 95% CI: 0.37–0.92), and 14-year (AOR: 0.54, 95% CI: 0.34–0.86); in a 14-year follow-up, a reduced risk of cognitive decline was observed among older people with higher reading frequencies versus lower ones at all educational levels. Conclusions: Reading was protective of cognitive function in later life. Frequent reading activities were associated with a reduced risk of cognitive decline for older adults at all levels of education in the long term.

Shopping behaviour favourably predicts survival. Highly frequent shopping may favour men more than women. Shopping captures several dimensions of personal well-being, health and security as well as contributing to the community's cohesiveness and economy and may represent or actually confer increased longevity.